| NPI | 1972703957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q7467) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 232570) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2024-06-29 |